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Chapter 13, Comfort and Pain Management
With the realization that pain is highly prevalent among older adults, please answer the following questions:

What are some ways you as the nurse can utilize to determine pain in the older adult?
 What are some of the potential barriers related  to self-reporting of pain in the older adult?

Please use your textbook as, at least, one reference
Please abide by APA 7th edition format in your writing. 
Answers should be 2-3 Paragraphs made up of 3-4 sentences each, at least 250 words (more or less) in length.

Gerontological
Nursing
Ninth Edition

2

Gerontological
Nursing
Ninth Edition

Charlotte Eliopoulos, PhD, MPH, RN
Specialist in Holistic Gerontological Care

3

Acquisitions Editor: Natasha McIntyre
Director of Product Development: Jennifer K. Forestieri
Development Editor: Meredith L. Brittain
Editorial Assistant: Leo Gray
Production Project Manager: Priscilla Crater
Design Coordinator: Elaine Kasmer
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Karin Duffield
Production Services/Compositor: SPi Global

9th Edition

Copyright © 2018 Wolters Kluwer

All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means,
including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book
prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To
request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
[email protected], or via our website at lww.com (products and services).

Nursing diagnoses in this title are reprinted with permission from: Herdman, T.H. & Kamisuru, S. (Eds.) Nursing Diagnoses — Definitions
and Classification 2015-2017. Copyright © 2014, 1994-2014 NANDA International. Used by arrangement with John Wiley & Sons Limited.
In order to make safe and effective judgments using NANDA-I nursing diagnoses it is essential that nurses refer to the definitions and defining
characteristics of the diagnoses listed in this work.

9 8 7 6 5 4 3 2 1

Printed in China

Cataloging in Publication data available on request from publisher
ISBN 9780060000387

This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy,
comprehensiveness, or currency of the content of this work.

This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration
of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to
the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and
not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. 

Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses,
indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should
consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the
manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify
any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow
therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or
damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of
this work.

LWW.com

4

mailto:[email protected]

http://lww.com

http://LWW.com

Not authorised for sale in United States, Canada, Australia, New Zealand, Puerto Rico, and U.S. Virgin Islands.

Acquisitions Editor: Natasha McIntyre
Director of Product Development: Jennifer K. Forestieri
Development Editor: Meredith L. Brittain
Editorial Assistant: Leo Gray
Production Project Manager: Priscilla Crater
Design Coordinator: Elaine Kasmer
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Karin Duffield
Production Services/Compositor: SPi Global

9th Edition

Copyright © 2018 Wolters Kluwer

All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means,
including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written
permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book
prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To
request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at
[email protected], or via our website at lww.com (products and services).

Nursing diagnoses in this title are reprinted with permission from: Herdman, T.H. & Kamisuru, S. (Eds.) Nursing Diagnoses — Definitions
and Classification 2015-2017. Copyright © 2014, 1994-2014 NANDA International. Used by arrangement with John Wiley & Sons Limited.
In order to make safe and effective judgments using NANDA-I nursing diagnoses it is essential that nurses refer to the definitions and defining
characteristics of the diagnoses listed in this work.

9 8 7 6 5 4 3 2 1

Printed in China

Cataloging in Publication data available on request from publisher
ISBN 9781496377258

This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy,
comprehensiveness, or currency of the content of this work.

This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration
of, among other things, age, weight, gender, current or prior medical conditions, medication history, laboratory data and other factors unique to
the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and
not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments. 

Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses,
indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should
consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the
manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify
any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow
therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or
damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of
this work.

LWW.com

5

mailto:[email protected]

http://lww.com

http://LWW.com

6

This book is dedicated to my husband, George Considine, for his unending patience, support, and encouragement.

7

Preface

Whether they are aware of it or not, most nurses today are doing some form of gerontological nursing.
Hospitals are caring for increasing numbers of older adults whose age-related changes, multiple diagnoses,
and psychosocial complexities present many challenges. Settings that provide long-term care are expanding
beyond the nursing home. More older adults are remaining in the community and presenting new demands
for nursing services to be provided in innovative ways. Growing numbers of older individuals are heading
multigenerational households and caring for younger family members, which brings them into contact with
nurses in specialties beyond geriatrics.

Not only do older individuals have a greater presence in various specialties but they also are presenting
new challenges. They are better informed about their health conditions and expect to have explanations for
treatment decisions. Many are using complementary and alternative therapies and desire approaches that
integrate those therapies into conventional care. They not only want their diseases managed but they also
want to enhance their function so they can enjoy an active, meaningful life. They may make choices that
forfeit treatments that can extend the quantity of life for those that offer the freedom to enjoy a high quality of
life for whatever time remains. Such challenges demand that nurses not only be knowledgeable about aging
and geriatric care but also skillful at assessing that which is important to the older person and providing care
that addresses the person holistically. It is indeed an exciting time to be a gerontological nurse!

Gerontological Nursing has evolved since its first publication. In the early editions of the text, the focus was
on providing facts about the aging process and the unique modifications that were necessary to properly assess,
plan, and provide care to older adults. We now understand that a “one size fits all” approach to nursing older
adults is inappropriate as the diversity of this population grows. In addition to expecting from the
gerontological nurse assistance with managing their medical conditions, today’s older adults may seek
guidance on the selection of brain exercises to improve mental function, the value of an herbal supplement
over their prescription drug, strategies to fill the void resulting from retiring from a job they enjoyed,
suggestions for the best lubricant to facilitate sexual intercourse, opinions as to the value of marijuana in
controlling their pain, and recommendations for the best type of approach to reduce their wrinkles. This
edition of Gerontological Nursing provides the evidence-based knowledge that can help the gerontological
nurse address, with competency and sensitivity, the complexities of meeting the comprehensive, holistic needs
of the older population.

8

Text Organization
Gerontological Nursing, Ninth Edition, is organized into five units. Unit 1, The Aging Experience, provides basic
knowledge about the older population and the aging process. The growing cultural and sexual diversity of this
population is discussed, along with the navigation of life transitions and the changes to the body and mind
that typically are experienced.

Unit 2, Foundations of Gerontological Nursing, provides an understanding of the development and scope of
the specialty, along with descriptions of the various settings that provide services to older persons. This unit
reviews legal and ethical issues that are relevant to gerontological nursing and offers guidance in applying a
holistic model to gerontological care.

Unit 3, Health Promotion, addresses the importance of measures to prevent illness and maximize function.
Chapters dedicated to nutrition and hydration, sleep and rest, comfort and pain management, safety, and
medications guide the nurse in promoting basic health and preventing avoidable complications. A chapter
dedicated to spirituality supports the holistic approach that is meaningful in gerontological care. In addition,
because people often feel sufficiently comfortable with nurses to discuss sensitive matters, a chapter on
sexuality and intimacy is included.

Unit 4, Geriatric Care, encompasses chapters dedicated to respiration, circulation, digestion and bowel
elimination, urinary elimination, reproductive system health, mobility, neurologic function, vision and
hearing, endocrine function, skin health, and cancer. A review of the impact of aging, interventions to
promote health, the unique presentation and treatment of illnesses, and integrative approaches to illness are
discussed within each of these areas. In addition to a chapter on mental health disorders, a chapter reviewing
delirium and dementia is included in recognition of the prevalence and care challenges of these conditions in
the geriatric population. Because chronic conditions affect most of this population, the last chapter of this unit
is dedicated to nursing actions that can assist older individuals in living a full life with chronic conditions.

The unique challenges gerontological nurses face in various care settings are discussed in Unit 5, Settings
and Special Issues in Geriatric Care. Chapters in this unit cover rehabilitative care, acute care, long-term care,
family caregiving, and end-of-life care.

9

Features
A variety of features enrich the content:

Learning Objectives prepare the reader for outcomes anticipated in reading the chapter.
Chapter Outlines present an overview of the chapter’s content.
Terms to Know define new terms pertaining to the topic.
Communication Tips offer suggestions to facilitate patient education and information exchange with
older adults.
Consider This Case features present clinical situations that offer opportunities for critical thinking.
Concept Mastery Alerts clarify fundamental nursing concepts to improve the reader’s understanding of
potentially confusing topics, as identified by Misconception Alerts in Lippincott’s Adaptive Learning
Powered by prepU.
Key Concepts emphasize significant facts.
Points to Ponder pose questions to stimulate thinking related to the content.
Assessment Guides outline the components of general observations, interview, and physical assessment
of major body systems.
Nursing Diagnosis Highlights provide an overview of selected nursing diagnoses common in older
adults.
Nursing Care Plans demonstrate the steps in developing nursing diagnoses, goals, and actions from
identified needs.
Bringing Research to Life presents current research and describes how to apply that knowledge in
practice.
Practice Realities pose real-life examples of challenges that could be faced by a nurse in practice.
Critical Thinking Exercises guide application.
Resources and References assist with additional exploration of the topic.

10

Teaching and Learning Package
A comprehensive teaching/learning package has been developed to assist faculty and students.

Resources for Instructors
Tools to assist you with teaching your course are available upon adoption of this text at
http://thePoint.lww.com/Eliopoulos9e.

An E-book on gives you access to the book’s full text and images online.
The Test Generator lets you put together exclusive new tests from a bank containing hundreds of
questions to help you in assessing your students’ understanding of the material. Test questions link to
chapter learning objectives. This test generator comes with a bank of more than 900 questions.
PowerPoint Presentations provide an easy way for you to integrate the textbook with your students’
classroom experience, via either slide shows or handouts. Multiple choice and true/false questions are
integrated into the presentations to promote class participation and allow you to use i-clicker
technology.
Clinical Scenarios posing What If questions (and suggested answers) give your students an opportunity
to apply their knowledge to a client case similar to the one they might encounter in practice.
Assignments (and suggested answers) include group, written, clinical, and web assignments.
An Image Bank lets you use the photographs and illustrations from this textbook in your PowerPoint
slides or as you see fit in your course.
A QSEN Competency Map and a BSN Essentials Map show you how content connects with these
important competencies.
Suggested Answers to the Critical Thinking Exercises in the book allow you to gauge whether students’
answers are on the right track by giving you main points that students are expected to address in the
answers.
Plus a Sample Syllabus, Strategies for Effective Teaching, and Learning Management System
Cartridges.

Resources for Students
An exciting set of free resources is available to help students review material and become even more familiar
with vital concepts. Students can access all these resources at http://thePoint.lww.com/Eliopoulos9e using the
codes printed in the front of their textbooks.

Current Journal Articles offer access to current research available in Wolters Kluwer journals.
Watch & Learn Video Clips explain How to Assist a Person Who Is Falling, Alternatives to Restraints,
and the Five Stages of Grief. (Icons in the textbook direct readers to relevant videos.)
Recommended Readings expand the network of available information.
Plus Learning Objectives from the textbook, Nursing Professional Roles and Responsibilities, and
Heart and Breath Sounds.

11

http://thePoint.lww.com/Eliopoulos9e.

http://thePoint.lww.com/Eliopoulos9e

12

A Fully Integrated Course Experience
We are pleased to offer an expanded suite of digital solutions and ancillaries to support instructors and
students using Gerontological Nursing, Ninth Edition. To learn more about any solution, please contact your
local Wolters Kluwer representative.

Lippincott CoursePoint+
Lippincott CoursePoint+ is an integrated digital learning solution designed for the way students learn. It is the
only nursing education solution that integrates:

Leading content in context: Content provided in the context of the student learning path engages
students and encourages interaction and learning on a deeper level.
Powerful tools to maximize class performance: Course-specific tools, such as adaptive learning powered
by prepU, provide a personalized learning experience for every student.
Real-time data to measure students’ progress: Student performance data provided in an intuitive display
lets you quickly spot which students are having difficulty or which concepts the class as a whole is
struggling to grasp.
Preparation for practice: Integrated virtual simulation and evidence-based resources improve student
competence, confidence, and success in transitioning to practice.

vSim for Nursing: Co-developed by Laerdal Medical and Wolters Kluwer, vSim for Nursing
simulates real nursing scenarios and allows students to interact with virtual patients in a safe,
online environment.
Lippincott Advisor for Education: With over 8,500 entries covering the latest evidence-based
content and drug information, Lippincott Advisor for Education provides students with the most
up-to-date information possible, while giving them valuable experience with the same point-of-
care content they will encounter in practice.

Training services and personalized support: To ensure your success, our dedicated educational
consultants and training coaches will provide expert guidance every step of the way.

13

Simulation and Other Resources

vSim for Nursing | Gerontology, a virtual simulation platform
(available via ). Co-developed by Laerdal Medical and Wolters Kluwer, vSim for Nursing | Gerontology
includes 12 gerontology patient scenarios that correspond to the National League for Nursing (NLN)
Advancing Care Excellence for Seniors (ACES) Unfolding Cases. vSim for Nursing | Gerontology helps
students develop clinical competence and decision-making skills as they interact with virtual patients in
a safe, realistic environment. vSim for Nursing records and assesses student decisions throughout the
simulation, then provides a personalized feedback log highlighting areas needing improvement.

Lippincott DocuCare (available via
thePoint). Lippincott DocuCare combines web-based electronic health record simulation software with
clinical case scenarios. Lippincott DocuCare’s nonlinear solution works well in the classroom,
simulation lab, and clinical practice.

14

Reviewers

Carol Amann, PhD, RN-BC, CDP

Assistant Professor for the Villa Maria School of Nursing
Gannon University
Erie, Pennsylvania

Jan Atwell, MSN, RN

Clinical Assistant Professor
Missouri State University
Springfield, Missouri

Judy L. Barrera, RN, CNS

Clinical Learning Lab Coordinator
Galen College of Nursing
Louisville, Kentucky

Evelyn Biray, RN, MS, PMed, CCRN, CMSRN

Professor of Nursing
Long Island University Brooklyn
New York, New York

Dr.Melissa Brock , MSM, MSN, ANP-C, DHEd

Nursing Professor
Indiana Wesleyan University
Indianapolis, Indiana

Celeste Brown-Apoh, RN, MSN

Instructor
Rowan College at Burlington County
Pemberton, New Jersey

Jean Burt, MSN, RN

Instructor
Wilbur Wright College
Chicago, Illinois

Nicola Contreras, MSN, RN

VN/ADN Faculty

15

Galen College of Nursing
San Antonio, Texas

Sherri Cozzens, RN, MS

Nursing Faculty
De Anza College
Cupertino, California

Jodie Fox, MSN, RN-BC

Assistant Professor
Viterbo University
Lacrosse, Wisconsin

Florida Freeman, PhD, MSN, RN

Professor of Nursing
University of St. Francis
Joliet, Illinois

Betsy D. Gulledge, PhD, RN, CNE, NEA-BC

Associate Dean/Assistant Professor of Nursing
Jacksonville State University
Jacksonville, Alabama

Kris Hale, MSN, RN

Professor/Department Chair
San Diego City College
San Diego, California

Cheryl Harrington, MSN, RN, MHA

Clinical Simulation Specialist
Morningside College
Sioux City, Iowa

Mary Jane Holman, RN

Instructor
Louisiana State University Shreveport
Shreveport, Louisiana

Laly Joseph, DVM, DNP, MSN, RN, C, ARNP, BC

Clinical Assistant Professor
Fairleigh Dickinson University
Teaneck, New Jersey

16

Ronnie Knabe, MSN, RN, CCRN

Associate Professor, Nursing
Bakersfield College
Bakersfield, California

Amy Langley

Health Science Division Director
Snead State Community College
Boaz, Alabama

Debora Lemon, MN, RN

Associate Professor
Lewis-Clark State College
Lewiston, Idaho

Susan McClendon, MSN, RN, CNS

Nursing Faculty
Lakeland Community College
Kirkland, Ohio

Mary Alice Momeyer, DNP, ANP-BC, GNP-BC

Assistant Clinical Professor
The Ohio State University
College of Nursing
Columbus, Ohio

Jon F. Nutting, MA, RN-BC

Instructor
Galen College of Nursing
Tampa Bay Campus
St. Petersburg, Florida

Teresa M. Page, DNP, EdS, MSN, RN, FNP-BC

Assistant Professor of Nursing
Liberty University
Lynchburg, Virginia

LoriAnn Pajalich, MS, RN, CNS, GCNS-BC

Assistant Professor of Nursing
Wilkes University
Wilkes-Barre, Pennsylvania

17

Debra Parker, DNP, RN

Assistant Professor
Indiana Wesleyan University
Marion, Indiana

Cordelia Schaffer, MSN, RN, CHPN

Associate Professor
Westminster College
Salt Lake City, Utah

Crystal Schauerte-O’Connell

Program Coordinator, Year 2
Algonquin College
Ottawa, Ontario

Maura C. Schlairet, EdD, MA, MSN, RN, CNL (A/H)

Professor of Nursing
Valdosta State University
Valdosta, Georgia

Nichole Spencer, MSN, APRN, ANP-C

Assistant Professor of Nursing
William Jewell College
Liberty, Missouri

Carolyn Sue-Ling, MSN, MPA, RN

Instructor
University of South Carolina Aiken
Aiken, South Carolina

Michael T. Valenti, AAS, BS, MS

Assistant Professor of Nursing
Long Island University
Brookville, New York

Stephanie Vaughn, PhD, RN, CRRN, FAHA

Professor/Director School of Nursing
California State University, Fullerton
Fullerton, California

Erica Williams-Woodley, MSN, NP

Assistant Professor of Nursing

18

Bronx Community College
New York, New York

Jane Zaccardi, MA, RN, GCNS-BC

Director of Practical Nursing and Health Occupations Programs
Johnson County Community College
Overland Park, Kansas

For a list of the contributors to the Instructor Resources and a list of the reviewers of the Test Generator
questions accompanying this book, please visit http://thepoint.lww.com/Eliopoulos9e.

19

http://thepoint.lww.com/Eliopoulos9e

Acknowledgments

There are many individuals who played important roles in the birth and development of this book. I will
always be grateful to Bill Burgower, a Lippincott editor, who decades ago responded to my urging that the
new specialty of gerontological nursing needed resources by encouraging me to write the first edition of
Gerontological Nursing. Many fine members of the Wolters Kluwer team have guided and assisted me since,
including Natasha McIntyre, Acquisitions Editor, who consistently offered encouragement and direction;
Meredith Brittain, Senior Development Editor, who brought a new set of eyes to the book and ironed out the
rough edges through her fine editorial skills; Dan Reilly and Leo Gray, Editorial Assistants at different points
in this project, who attended to the details that contribute to a quality finished product; and Priscilla Crater,
Production Project Manager, who shepherded the book from manuscript through printed pages.

Lastly, I am deeply indebted to those mentors and leaders in gerontological care who generously offered
encouragement and the many older adults who have touched my life and showed me the wisdom and beauty
of aging. The insight these individuals provided could have never been learned in a book!

Charlotte Eliopoulos

20

Brief Contents

UNIT 1 THE AGING EXPERIENCE
1 The Aging Population
2 Theories of Aging
3 Diversity
4 Life Transitions and Story
5 Common Aging Changes

UNIT 2 FOUNDATIONS OF GERONTOLOGICAL NURSING
6 The Specialty of Gerontological Nursing
7 Holistic Assessment and Care Planning
8 Legal Aspects of Gerontological Nursing
9 Ethical Aspects of Gerontological Nursing
10 Continuum of Care in Gerontological Nursing

UNIT 3 HEALTH PROMOTION
11 Nutrition and Hydration
12 Sleep and Rest
13 Comfort and Pain Management
14 Safety
15 Spirituality
16 Sexuality and Intimacy
17 Safe Medication Use

UNIT 4 GERIATRIC CARE
18 Respiration
19 Circulation
20 Digestion and Bowel Elimination
21 Urinary Elimination
22 Reproductive System Health
23 Mobility
24 Neurologic Function
25 Vision and Hearing

21

26 Endocrine Function
27 Skin Health
28 Cancer
29 Mental Health Disorders
30 Delirium and Dementia
31 Living in Harmony With Chronic Conditions

UNIT 5 SETTINGS AND SPECIAL ISSUES IN GERIATRIC CARE
32 Rehabilitative and Restorative Care
33 Acute Care
34 Long-Term Care
35 Family Caregiving
36 End-of-Life Care

Index

22

Contents

UNIT 1 THE AGING EXPERIENCE
1 The Aging Population
Views Of Older Adults Through History

Characteristics Of The Older Adult Population

Population Growth and Increasing Life Expectancy
Marital Status and Living Arrangements
Income and Employment

Health Insurance

Health Status
Implications Of An Aging Population

Impact of the Baby Boomers
Provision of and Payment for Services

2 Theories of Aging
Biological Theories Of Aging

Stochastic Theories
Nonstochastic Theories

Sociologic Theories of Aging

Disengagement Theory
Activity Theory
Continuity Theory
Subculture Theory
Age Stratification Theory

Psychological Theories of Aging

Developmental Tasks
Gerotranscendence

Nursing Theories of Aging

Functional Consequences Theory
Theory of Thriving
Theory of Successful Aging

Applying Theories of Aging to Nursing Practice

3 Diversity
Increasing Diversity Of The Older Adult Population

Overview Of Diverse Groups Of Older Adults In The United States

Hispanic Americans
Black Americans
Asian Americans
Jewish Americans

23

Native Americans
Muslims
Gay, Lesbian, Bisexual, and Transgender Older Adults

Nursing Considerations For Culturally Sensitive Care Of Older Adults

4 Life Transitions and Story
Ageism

Changes In Family Roles And Relationships

Parenting
Grandparenting

Loss Of Spouse

Retirement

Loss of the Work Role
Reduced Income

Changes In Health And Functioning

Cumulative Effects Of Life Transitions

Shrinking Social World
Awareness of Mortality

Responding To Life Transitions

Life Review and Life Story
Self-Reflection
Strengthening Inner Resources

5 Common Aging Changes
Changes To The Body

Cells
Physical Appearance
Respiratory System
Cardiovascular System
Gastrointestinal System
Urinary System
Reproductive System
Musculoskeletal System
Nervous System
Sensory Organs
Endocrine System
Integumentary System
Immune System
Thermoregulation

Changes To The Mind

Personality
Memory
Intelligence

24

Learning
Attention Span

Nursing Implications Of Age-Related Changes

UNIT 2 FOUNDATIONS OF GERONTOLOGICAL NURSING
6 The Specialty of Gerontological Nursing
Development Of Gerontological Nursing

Core Elements Of Gerontological Nursing Practice

Evidence-Based Practice
Standards
Competencies
Principles

Gerontological Nursing Roles

Healer
Caregiver
Educator
Advocate
Innovator

Advanced Practice Nursing Roles

Self-Care And Nurturing

Following Positive Health Care Practices
Strengthening and Building Connections
Committing to a Dynamic Process

The Future Of Gerontological Nursing

Utilize Evidence-Based Practices
Advance Research
Promote Integrative Care
Educate Caregivers
Develop New Roles
Balance Quality Care and Health Care Costs

7 Holistic Assessment and Care Planning
Holistic Gerontological Care

Holistic Assessment Of Needs

Health Promotion–Related Needs
Health Challenges–Related Needs
Requisites to Meet Needs

Gerontological Nursing Processes

Examples Of Application

Applying the Holistic Model: The Case of Mrs. D
The Nurse As Healer

Healing Characteristics

25

8 Legal Aspects of Gerontological Nursing
Laws Governing Gerontological Nursing Practice

Legal Risks In Gerontological Nursing

Malpractice
Confidentiality
Patient Consent
Patient Competency
Staff Supervision
Medications
Restraints
Telephone Orders
Do Not Resuscitate Orders
Advance Directives and Issues Related to Death and …

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